Tag: Major depressive disorder

New mothers have a much higher rate of obsessive-compulsive symptoms than other people and these symptoms center on their baby’s well-being, a new study indicates.

For example, a new mother may constantly worry and check to see if her baby is still breathing; she may obsess about germs and whether she’s properly sterilized the baby’s bottles and then wash or rewash them; or she may be unduly concerned about injuring her baby, according to the study authors.

The researchers surveyed hundreds of new mothers and found that 11 percent of them had significant obsessive-compulsive symptoms at two weeks and at six months after giving birth. The rate in the general population is 2 percent to 3 percent.

These symptoms are usually temporary and could result from hormonal changes or may be an adaptive response to caring for a new baby, the researchers suggested. They found that about 50 percent of the women reported an improvement in their symptoms by six months. However, some women who did not have symptoms at two weeks developed them at six months.

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” study senior author Dr. Dana Gossett, chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital, said in a Northwestern Medicine news release.

But if these symptoms interfere with normal day-to-day functioning and appropriate care for the baby and parent, they may indicate a mental health problem, the investigators pointed out.

About 70 percent of the women who had obsessive-compulsive symptoms also haddepression symptoms. This suggests that obsessive-compulsive disorder in new mothers represents a distinct mental illness, said study lead author Dr. Emily Miller, a clinical fellow in maternal-fetal medicine at Feinberg.

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” Miller said in the news release. “Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

The study appears in the March/April issue of the Journal of Reproductive Medicine.

Have you ever had an emotional or mental breakdown? I have. At the time I was doing martial arts several times a week, was involved in a spiritual community, was learning and growing, but none of that seemed to matter.

So what happened?

Clinicians often refer to a nervous breakdown as technically an “adjustment disorder“. Your external work gets kicked in the spleen so hard that no amount of yoga or protein shakes or Mona Vie bars can hope to compete. Your inside world is depressed, or anxious, or panicked, or all of the above. Often psychosis shows up with tequila shots for the party. Your world crumbles and you simply can no longer cope. Sound like anyone you know?

People who have never been in a severe depression or have had a breakdown cannot hope to understand why people often consider suicide. To the outsider, suicide is a coward’s way out, or a selfish act, or just plain crazy. True enough on one level – crazy does certainly show up. It is hard to understand from a distance, but when things get that bad one is not thinking in their rational mind. Obsession has become a way of life. They call it a “breakdown” for a reason.

Most of us do not realize that we have several gauges of health. Until someone told me I believed that if I was working out, eating right, and learning and growing, I would be fine when things went sideways. I did not realize, and did not pay attention to, my emotional gauge.

Working out, eating broccoli, and going to a church does not necessarily mean that you are not emotionally bankrupt. Those things may help to keep you healthy, but put a group of emotional succubus’ in your life and things start to go wrong.

When you pause to think about it, there is usually three kinds of people in your life. There are those who, after you have spent time with, you feel better for having been together. Then there are those who do not affect you one way or the other.

Did I mention there were three groups? You know the last group. When they call a piece of you dies inside. Being with them sucks the life out of you. They are never happy, or always complaining, or your mother. People like this drain your emotional gauge. Add a relational breakdown, or a child who is unruly, a job that is stressful, and someone who is disappointed in you and you can begin to lose hope. Add to this the crazy schedule we all try to maintain with little or no time for reflection or self-care and you have a recipe for a meltdown.

Don’t even get me started on those of you who also have small children.

Taking care of your emotional stuff is the best thing you can do for yourself besides taking a week on a beach somewhere without a cell phone or your children. Paying attention to your emotional gauge will help you in ways you could never imagine. A healthy person with a healthy heart is the best defence against hurt, stress, and pain.

Anxiety and depression are plaguing 21st Century culture. It’s an epidemic.

We have never had better medications to provide relief, never had better therapies available. Health care, thorough physicians, EAP programs for free counseling, nurses, and other professionals has never been as accessible.There is no world war, most of us do not have a terminal illness. Employment is at an all time low. So what is the problem? Is there any hope?

Day after day people tell me in counseling that they have been dealing with anxiety and depression for years, even decades. They have been on antidepressants literally for generations. They believe that they have a biological issue, some sort of genetic flaw, though no one can identify when or how they were tested to confirm the neurochemical prognosis. Many people, at least in my part of the world have seen a psychiatrist who, after ten or twenty minutes, has diagnosed them (without any evidence-based analysis) as having a depressive or anxiety disorder. I have asked these individual what tests were run, what scale was used; did you even fill out a Burns Depression Questionnaire, or a PHQ-9, or a HAM-A/D, a GAD-7? Anything? Did you share the story of your past few years, describe the emotional and psychological stressors?

Twenty minutes every month and a prescription for an antidepressant, a benzodiazepine, and a sleeping medication. Many, many of my patients have been taking these same medications for a decade or more and have no idea if they do anything substantive.

The hard truth is that taking medication for a generalized anxiety or depressive disorder is only a small part of the solution (though perhaps necessary); and by themselves do little to address the important questions. Dealing with anxiety and depression requires actually dealing with the key causes, issues and effects, and takes a tremendous amount of learning, transition, and vigilance.

I tell patients that the tools they need to address these issues are incredibly simple to learn and very very difficult to master. This requires a level of humility and dedication most people are not willing to give. If you have a major issue with anxiety or depression it is going to take major work. But with the right tools, a counselor that doesn’t suck, and a dedication to do ‘whatever it takes’, you can experience significant change in just a few months.

But you need the right tools. If you go to a counselor and they tell you that you need to begin by changing your lifestyle (like the doctor who tells you to fight depression by going for a long walk every morning) then fire that therapist. Real change begins with changing your mind, not your activities or emotions. A counselor who knows what they are doing will challenge you to deal with your thoughts, show you how to practice taking back control of your impulses, and help you learn to address your dysfunctional coping skills and cognitive distortions.

With depression, for example, if you could go for a long walk every morning you probably wouldn’t be talking to your doctor. A person who is seriously depressed is usually unable to find the energy or motivation to open the curtains, let alone go for long hikes. So once again you are a failure, only further entrenching your despondency. A good counselor will help you find hope, not set you up for more failure.

Depressed people can get better. Every day I teach people the tools they need to find hope. The problem is that not everyone is prepared for the relentless battle that is necessary to drag your emotions and garbage, kicking and screaming, back into your control. You will have to fight your own dysfunctional thinking and learn to get control of your mind, battle your obsessions, say no to your desires, and question your own beliefs. This is a great deal of work and pain but the reward is sanity, hope, and a shot at a happy life.

I love what Tony Campolo once said, “As children we were taught to pray the prayer, ‘If I should die before I wake’. Most of us should be praying, ‘If I should wake before I die’.” Many of us have been walking around most of our lives half asleep, half alive. Isn’t it time we woke up? Anxiety is not a terminal illness. Panic attacks can be beaten. Depressed people find hope.

I counsel literally hundreds of people each year who are battling depression. While there is clear evidence that some depression is biological in nature, most, by far the vast majority, of cases I work with are people who, at least at one time, had a situation that sparked the emotional decline. This is called, captain obvious, ‘situational depression‘, or lingering adjustment disorder. Untreated, or treated incorrectly, this often slides into a Major Depressive Disorder, or MDD.

Someone died, you developed chronic pain or Fibromyalgia, you lost your job, your partner ran away with that idiot from your church, you have grown up with criticism or insecurity, you were abused. Life has kicked you down and kept you there. Trust me, I am sympathetic in spite of the title. But it’s about time someone called it like it is.

Depression shouldn’t be a terminal illness. You shouldn’t have to take antidepressants for forty years because you can never truly live again. But so many of us do and it’s ridiculous.

You’ve been sold a lie. Maybe it was your doctor or your psychiatrist or your uncle Biff but for some reason you think you have to live with depression, cope with this demon for the rest of your life. After all, didn’t your mom and your grandmother and all your relatives back to Foofoo The Wonder Ape have depression?

I hear this from new clients and patients all the time.

The problem with most of psychiatry is that they simply don’t have the time to counsel you until you can get better. They get paid by the number of patients they see every day – they work on commission. It’s a lot easier to just throw some SSRI your way and book another appointment in a month. I work at a medical clinic and the shear volume of need is simply overwhelming. The reality looks very little like the perceptions of psychiatry in popular culture (Analyze This, Lie to Me, Good Will Hunting, What About Bob? etc.)

And don’t get me started on crappy counselors. Every week I hear about abuse and basic incompetency over and over again. Going to school or taking a course doesn’t make you a good counselor any more than eating a salad makes you a carrot. I’ve said it before and I’ll keep saying it until someone pays attention – most counselors suck!

Fortunately there are some counselors out there who understand about depression and are willing to try to move you beyond a life of bondage. I hope I am considered one of those people. Using a combination of current and evolving evidence-based therapies, sometimes in combination with medications, hundreds and thousands of people are finding hope and relief, as well as an opportunity to become a “normie” once again.

Don’t settle for a life of depression and hopelessness. I will be addressing this at length with my email subscribers and offering some practical information that WORKS.

Oh ya, and hire a counselor who doesn’t suck… (which I will help you with).